A journey to Vietnam and back

If you are planning a trip to a small country of more than 90 million people that’s rich in culture and traditions, you can imagine the kind of travel itinerary you’d keep. For Timothy J. Craig, D.O., professor of medicine and pediatrics, that itinerary looked quite different. Craig recently completed an eighteen-month fellowship in Vietnam where he spent time at a few different hospitals providing clinical, educational, and research support to help improve their overall quality of care.

Craig’s fellowship was part of the Vietnam Education Foundation federal grant, which supports educational exchange. “It was an incredible experience. When you go over once as a tourist, you don’t meet a lot of people,” describes Craig. “When you go six or seven times, you start to know the people and get invited into their homes and to their weddings.”

Originally, Craig had planned to work at the Lung Hospital in Hanoi to develop a protocol to determine adverse effects to drugs used for tuberculosis (TB). Then, his work led him to the Allergy Center in Hanoi. “There, I did some quality assurance programs. I retrained them on how to do their skin tests and went through some different ways to perform pulmonary function tests,” says Craig. He then travelled south to Ho Chi Minh City, where he worked with the ENT Hospital. There he taught staff how to do various allergy tests and how to incorporate that into their practice. “At this hospital, I saw that they hadn’t had the opportunity to determine what people were allergic to, so I helped them set up a holistic allergy clinic,” said Craig.

One of the things he continually emphasized in his training was quality assurance. It was during this retraining process that he realized they were not changing the filters on the machines they use to conduct breathing tests. “Unfortunately, in a country that has a high rate of TB, you want to change those filters each time, because someone can re-inhale a deposit left from someone else,” explains Craig.

Craig speaks of his experience in Vietnam with a warm fondness. “The people I met there were very open and friendly and excited to work with me,” he explains. His passion for improving the health care system in Vietnam is also evident. “The health care system is really overburdened. The physicians try very hard with what they have, but there are limitations in equipment and other areas,” says Craig. As part of his grant, he was able to purchase and donate $20,000 worth of equipment to help his many collaborators.

For Craig, it is not a matter of if he is going back to Vietnam, but when. He is already searching out new grant opportunities, so he can continue his work there. “One of my major projects is to complete the development of the TB drug protocol. TB is very prevalent in Vietnam, and individuals have to be on three to four medications because it changes so much. Developing a protocol would help physicians better assess adverse events and allergic reactions.” Craig also plans to return to Ho Chi Minh City to work with one of their pediatric hospitals. “The prevalence of asthma is increasing, and they want to address that by building a state-of-the-art asthma center,” he says.

He also has not forgotten about the filters being reused in the breathing machines, and he intends to talk to someone in engineering at Penn State to help develop an affordable device that will help them avoid having multiple people breathing into the same filter. Lastly, he feels there’s a real opportunity to study asthma rates. “Vietnam is going through an industrial boom, so there’s an increase of allergies and prevalence of asthma,” Craig says. “My long-term goal is to study the changes of asthma prevalence, and then help establish asthma centers in response to it.” With so many goals still to accomplish, it is clear that Craig has a steadfast commitment to improving health care in Vietnam, and that he will continue to collaborate with colleagues here and abroad in his global health outreach efforts for years to come.